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We would like you to share your example of how your agency/organization has implemented a program, tackled a problem, taken advantage of an opportunity, or otherwise worked to improve health outcomes in your community or state. DPH staff will follow up with you to gather any additional information that might be needed to turn your example into a story that can be shared with others through the SHIP e-newsletter.

First Name Last Name

Phone Email

Agency/Organization

Does your example address any of the following SHIP Focus Areas?

Chronic Disease Prevention Injury and Violence Prevention

Environmental Health Maternal, Infant and Child Health

Health Systems Mental Health and Substance Abuse

Infectious Disease Prevention Other

Public Health Topic Area:

Briefly describe the challenge or issue you needed to address:

Briefly describe your program or solution:

What partners helped with the solution and what role did they play?

What outcomes did you see as a result of your efforts and collaboration?